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Treating Depression in Adolescents and Young Adults Using Remote Intensive Outpatient Programs: Quality Improvement
Michelle Evans-Chase1, Phyllis Solomon1, Bethany Peralta2
1School of Social Policy & Practice, University of Pennsylvania, Philadelphia, PA, United States.
JMIR Formative Research
|April 11, 2023
Summary
Remote intensive outpatient programming significantly reduced depression symptoms in youth and young adults. This accessible treatment model shows promise for diverse populations, including LGBTQ+ individuals.
Area of Science:
- Mental Health
- Adolescent Psychiatry
- Digital Health
Background:
- Youth face significant barriers to mental health care, including limited program availability and a lack of developmentally appropriate services.
- Geographic limitations of traditional intensive outpatient programs (IOPs) exacerbate health disparities, particularly for those with high-acuity mental health needs.
- Place-based IOPs require clients to travel, limiting access for many young individuals.
Purpose of the Study:
- To evaluate the effectiveness of remote intensive outpatient programming (RIOP) in treating depression among youth and young adults.
- To assess changes in depression symptoms from intake to discharge in a RIOP setting.
- To inform quality improvement efforts and programmatic decisions within mental health services for young people.
Main Methods:
- Utilized outcomes data collected at intake and discharge for 1062 cases diagnosed with depression.
- Employed the Patient Health Questionnaire (PHQ) adapted for adolescents to measure depression.
- Applied repeated measures t-tests for depression changes and McNemar chi-square analyses for clinical symptom shifts; ANOVA used for subgroup analyses.
Main Results:
- Significant reductions in depression symptoms were observed between intake and discharge (mean difference -6.06, P<.001).
- Over half of clients (53%) experienced a decrease in depression symptoms below the clinical cutoff for major depressive disorder.
- No significant differences in treatment outcomes were found across age, gender identity, or sexual orientation subgroups.
Conclusions:
- Remote intensive outpatient programming is a viable and effective alternative to traditional place-based treatment for youth depression.
- The RIOP model demonstrates efficacy for marginalized youth, including those identifying with diverse gender identities and sexual orientations.
- This approach is crucial for addressing treatment gaps and improving outcomes for underserved youth populations.
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